Katsavelis Dimitrios, Siu Ka-Chun, Brown-Clerk Bernadette, Lee Irene H, Lee Yong Kwon, Oleynikov Dmitry, Stergiou Nick
HPER Biomechanics Lab, University of Nebraska at Omaha, Omaha, NE 68182-0216, USA.
Surg Endosc. 2009 Jan;23(1):66-73. doi: 10.1007/s00464-008-9894-z. Epub 2008 Apr 10.
A robotic virtual-reality (VR) simulator has been developed to improve robot-assisted training for laparoscopic surgery and to enhance surgical performance in laparoscopic skills. The simulated VR training environment provides an effective approach to evaluate and improve surgical performance. This study presents our findings of the VR training environment for robotic laparoscopy.
Eight volunteers performed two inanimate tasks in both the VR and the actual training environment. The tasks were bimanual carrying (BC) and needle passing (NP). For the BC task, the volunteers simultaneously transferred two plastic pieces in opposite directions five times consecutively. The same volunteers passed a surgical needle through six pairs of holes in the NP task. Both tasks require significant bimanual coordination that mimics actual laparoscopic skills. Data analysis included time to task completion, speed and distance traveled of the instrument tip, as well as range of motion of the subject's wrist and elbow of the right arm. Electromyography of the right wrist flexor and extensor were also analyzed. Paired t-tests and Pearson's r were used to explore the differences and correlations between the two environments.
There were no significant differences between the actual and the simulated VR environment with respect to the BC task, while there were significant differences in almost all dependent parameters for the NP task. Moderate to high correlations for most dependent parameters were revealed for both tasks.
Our data shows that the VR environment adequately simulated the BC task. The significant differences found for the NP task may be attributed to an oversimplification in the VR environment. However, they do point to the need for improvements in the complexity of our VR simulation. Further research work is needed to develop effective and reliable VR environments for robotic laparoscopic training.
已开发出一种机器人虚拟现实（VR）模拟器，以改进机器人辅助腹腔镜手术训练并提高腹腔镜技能的手术表现。模拟的VR训练环境提供了一种评估和提高手术表现的有效方法。本研究展示了我们在机器人腹腔镜手术VR训练环境方面的研究结果。
八名志愿者在VR和实际训练环境中都执行了两项无生命物体任务。任务分别是双手搬运（BC）和穿针（NP）。对于BC任务，志愿者连续五次同时向相反方向转移两块塑料片。同样的志愿者在NP任务中要将一根手术针穿过六对孔。这两项任务都需要显著的双手协调能力，模拟了实际的腹腔镜技能。数据分析包括任务完成时间、器械尖端移动的速度和距离，以及受试者右臂手腕和肘部的活动范围。还分析了右手腕屈肌和伸肌的肌电图。使用配对t检验和皮尔逊相关系数来探究两种环境之间的差异和相关性。
在BC任务方面，实际环境和模拟的VR环境之间没有显著差异，而在NP任务的几乎所有相关参数上都存在显著差异。两项任务的大多数相关参数都显示出中度到高度的相关性。
我们的数据表明VR环境充分模拟了BC任务。NP任务中发现的显著差异可能归因于VR环境过于简化。然而，这些差异确实表明需要改进我们VR模拟的复杂性。需要进一步开展研究工作，以开发用于机器人腹腔镜训练的有效且可靠的VR环境。
